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Q. What are the causes of bracket dislodgement?

Answered by
Dr. Mayank Khandelwal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 28, 2023

Hi doctor,

My brackets got dislodged, and it had come out with the cement. Is it my fault or the dentist's fault? Kindly suggest.

#

Hello,

Welcome to icliniq.com.

I understand your concern. The bracket dislodgement is normal and can happen to any patient. It can be due to the following causes:

1. During bracket placement, the tooth surface is conditioned, and the composite (dental cement) is placed on the bracket base and bonded to the tooth. In this process, there should not be any saliva contamination which can cause the process to fail. If there is saliva contamination, optimal strength is not obtained, and the bracket may break from the tooth surface. This could occur from the wire placement to the bracket to a few minutes later when you leave the dental office.

2. Biting on hard foods can cause the brackets to break and detach from the tooth surface.

3. It can also break if the bracket is bonded well and there have been no high bite forces, but the wire placed is causing higher forces. This could happen in cases where there is crowding and malalignment and if the doctor had fixed the wire a bit forcefully.

4. It can occur if the amount of composite is less than optimal on the bracket base.

These are the possible causes of bracket breakages and could be anyone's fault. In general, it is assumed, that if the composite is attached to the tooth surface and the bracket has come off, it could be due to high biting forces. If the composite has come off along with the bracket, there could be poor isolation of the tooth, and saliva contamination has occurred, reducing the strength.

I suggest visiting the doctor. He or she will repeat the process of bracket placement followed by archwire placement. If you feel the wire forces are high enough, you can ask the doctor to put a lower force wire in the initial appointment.

I hope this helps you.

Thank you.


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